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HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 401k Plan overview

Plan NameHEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S
Plan identification number 505

HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

CAL FARLEY'S BOYS RANCH has sponsored the creation of one or more 401k plans.

Company Name:CAL FARLEY'S BOYS RANCH
Employer identification number (EIN):750808768
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about CAL FARLEY'S BOYS RANCH

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1939-03-14
Company Identification Number: 0007484601
Legal Registered Office Address: PO BOX 1890

AMARILLO
United States of America (USA)
79174

More information about CAL FARLEY'S BOYS RANCH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052023-01-01
5052022-01-01
5052021-01-01
5052020-01-01
5052020-01-01
5052019-01-01
5052018-01-01
5052017-01-01WENDY KRITSER HOWARD
5052016-01-01MEGAN JOHNSON
5052015-01-01MEGAN JOHNSON
5052014-01-01MEGAN CRAWFORD
5052013-01-01DEIDRE BALLOU DEIDRE BALLOU2014-10-08
5052012-01-01DEDE BALLOU
5052011-01-01DEDE BALLOU
5052009-01-01DEDE BALLOU

Plan Statistics for HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S

401k plan membership statisitcs for HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S

Measure Date Value
2023: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2023 401k membership
Total participants, beginning-of-year2023-01-01306
Total number of active participants reported on line 7a of the Form 55002023-01-01488
Number of retired or separated participants receiving benefits2023-01-010
Total of all active and inactive participants2023-01-01488
2022: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2022 401k membership
Total participants, beginning-of-year2022-01-01342
Total number of active participants reported on line 7a of the Form 55002022-01-01305
Number of retired or separated participants receiving benefits2022-01-010
Total of all active and inactive participants2022-01-01305
2021: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2021 401k membership
Total participants, beginning-of-year2021-01-01364
Total number of active participants reported on line 7a of the Form 55002021-01-01335
Total of all active and inactive participants2021-01-01335
2020: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2020 401k membership
Total participants, beginning-of-year2020-01-01397
Total number of active participants reported on line 7a of the Form 55002020-01-01362
Number of retired or separated participants receiving benefits2020-01-012
Total of all active and inactive participants2020-01-01364
2019: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2019 401k membership
Total participants, beginning-of-year2019-01-01391
Total number of active participants reported on line 7a of the Form 55002019-01-01396
Number of retired or separated participants receiving benefits2019-01-012
Total of all active and inactive participants2019-01-01398
2018: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2018 401k membership
Total participants, beginning-of-year2018-01-01410
Total number of active participants reported on line 7a of the Form 55002018-01-01391
Number of retired or separated participants receiving benefits2018-01-0117
Total of all active and inactive participants2018-01-01408
2017: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2017 401k membership
Total participants, beginning-of-year2017-01-01421
Total number of active participants reported on line 7a of the Form 55002017-01-01384
Number of retired or separated participants receiving benefits2017-01-0126
Total of all active and inactive participants2017-01-01410
2016: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2016 401k membership
Total participants, beginning-of-year2016-01-01457
Total number of active participants reported on line 7a of the Form 55002016-01-01447
Number of retired or separated participants receiving benefits2016-01-0133
Total of all active and inactive participants2016-01-01480
2015: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2015 401k membership
Total participants, beginning-of-year2015-01-01481
Total number of active participants reported on line 7a of the Form 55002015-01-01426
Number of retired or separated participants receiving benefits2015-01-0137
Total of all active and inactive participants2015-01-01463
2014: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2014 401k membership
Total participants, beginning-of-year2014-01-01550
Total number of active participants reported on line 7a of the Form 55002014-01-01436
Number of retired or separated participants receiving benefits2014-01-0145
Total of all active and inactive participants2014-01-01481
2013: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2013 401k membership
Total participants, beginning-of-year2013-01-01526
Total number of active participants reported on line 7a of the Form 55002013-01-01473
Number of retired or separated participants receiving benefits2013-01-0177
Total of all active and inactive participants2013-01-01550
2012: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2012 401k membership
Total participants, beginning-of-year2012-01-01490
Total number of active participants reported on line 7a of the Form 55002012-01-01454
Number of retired or separated participants receiving benefits2012-01-0172
Total of all active and inactive participants2012-01-01526
2011: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2011 401k membership
Total participants, beginning-of-year2011-01-01494
Total number of active participants reported on line 7a of the Form 55002011-01-01433
Number of retired or separated participants receiving benefits2011-01-0157
Total of all active and inactive participants2011-01-01490
2009: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2009 401k membership
Total participants, beginning-of-year2009-01-01547
Total number of active participants reported on line 7a of the Form 55002009-01-01463
Number of retired or separated participants receiving benefits2009-01-0159
Total of all active and inactive participants2009-01-01522

Financial Data on HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S

Measure Date Value
2023 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2023 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$410,072
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$389,841
Total income from all sources (including contributions)2023-12-31$2,828,934
Total of all expenses incurred2023-12-31$3,212,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$3,045,525
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$2,747,285
Value of total assets at end of year2023-12-31$1,465,210
Value of total assets at beginning of year2023-12-31$1,829,002
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$167,432
Total interest from all sources2023-12-31$81,649
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$410,447
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2023-12-31$20,231
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$-384,023
Value of net assets at end of year (total assets less liabilities)2023-12-31$1,055,138
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$1,439,161
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$1,465,210
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$1,829,002
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$1,829,002
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-12-31$81,649
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$134,271
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31Yes
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$2,336,838
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$2,891,023
Contract administrator fees2023-12-31$167,432
Liabilities. Value of benefit claims payable at end of year2023-12-31$410,072
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$389,841
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31MOSS ADAMS LLP
Accountancy firm EIN2023-12-31910189318
2022 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$389,841
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$334,457
Total income from all sources (including contributions)2022-12-31$2,989,345
Total of all expenses incurred2022-12-31$3,181,214
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,003,310
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,966,242
Value of total assets at end of year2022-12-31$1,829,002
Value of total assets at beginning of year2022-12-31$1,965,487
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$177,904
Total interest from all sources2022-12-31$23,103
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$440,988
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$55,384
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-191,869
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,439,161
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,631,030
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,829,002
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,965,487
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,965,487
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$23,103
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$122,353
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$2,525,254
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,825,573
Contract administrator fees2022-12-31$177,904
Liabilities. Value of benefit claims payable at end of year2022-12-31$389,841
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$334,457
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MOSS ADAMS LLP
Accountancy firm EIN2022-12-31910189318
2021 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$53,547
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$456,833
Total income from all sources (including contributions)2021-12-31$3,331,148
Total of all expenses incurred2021-12-31$2,877,943
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,701,852
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,330,947
Value of total assets at end of year2021-12-31$1,965,487
Value of total assets at beginning of year2021-12-31$1,915,568
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$176,091
Total interest from all sources2021-12-31$201
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$200,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,496,644
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$-403,286
Administrative expenses (other) incurred2021-12-31$2,880
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$453,205
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,911,940
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,458,735
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,965,487
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$1,915,568
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$1,915,568
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$201
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$121,489
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$834,303
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$2,983,649
Contract administrator fees2021-12-31$173,211
Liabilities. Value of benefit claims payable at end of year2021-12-31$53,547
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$456,833
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MOSS ADAMS LLP
Accountancy firm EIN2021-12-31910189318
2020 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$465,676
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$495,566
Total income from all sources (including contributions)2020-12-31$3,702,818
Total of all expenses incurred2020-12-31$3,900,567
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,767,587
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$3,691,088
Value of total assets at end of year2020-12-31$1,915,568
Value of total assets at beginning of year2020-12-31$2,143,207
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$132,980
Total interest from all sources2020-12-31$11,730
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$200,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$2,844,325
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$-29,890
Administrative expenses (other) incurred2020-12-31$3,516
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-197,749
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,449,892
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,647,641
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$1,915,568
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$2,143,207
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$2,143,207
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$11,730
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$133,172
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$846,763
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$3,664,305
Contract administrator fees2020-12-31$129,464
Liabilities. Value of benefit claims payable at end of year2020-12-31$465,676
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$495,566
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31MOSS ADAMS LLP
Accountancy firm EIN2020-12-31910189318
2019 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$495,566
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$495,566
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$302,114
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$302,114
Total income from all sources (including contributions)2019-12-31$4,598,251
Total income from all sources (including contributions)2019-12-31$4,598,251
Total of all expenses incurred2019-12-31$3,651,508
Total of all expenses incurred2019-12-31$3,651,508
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,515,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,515,661
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,565,749
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,565,749
Value of total assets at end of year2019-12-31$2,143,207
Value of total assets at end of year2019-12-31$2,143,207
Value of total assets at beginning of year2019-12-31$1,003,012
Value of total assets at beginning of year2019-12-31$1,003,012
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$135,847
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$135,847
Total interest from all sources2019-12-31$32,502
Total interest from all sources2019-12-31$32,502
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$200,000
Value of fidelity bond cover2019-12-31$200,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$750,720
Contributions received from participants2019-12-31$750,720
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$193,452
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$193,452
Administrative expenses (other) incurred2019-12-31$2,440
Administrative expenses (other) incurred2019-12-31$2,440
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$946,743
Value of net income/loss2019-12-31$946,743
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,647,641
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,647,641
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$700,898
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$700,898
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,143,207
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,143,207
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,003,012
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,003,012
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,003,012
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,003,012
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$32,502
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$32,502
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$133,358
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$133,358
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$3,815,029
Contributions received in cash from employer2019-12-31$3,815,029
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$3,188,851
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$3,188,851
Contract administrator fees2019-12-31$133,407
Contract administrator fees2019-12-31$133,407
Liabilities. Value of benefit claims payable at end of year2019-12-31$495,566
Liabilities. Value of benefit claims payable at end of year2019-12-31$495,566
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$302,114
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$302,114
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MOSS ADAMS LLP
Accountancy firm name2019-12-31MOSS ADAMS LLP
Accountancy firm EIN2019-12-31910189318
Accountancy firm EIN2019-12-31910189318
2018 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$302,114
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$195,907
Total income from all sources (including contributions)2018-12-31$3,104,278
Total of all expenses incurred2018-12-31$3,098,282
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,974,457
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$3,083,712
Value of total assets at end of year2018-12-31$1,003,012
Value of total assets at beginning of year2018-12-31$890,809
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$123,825
Total interest from all sources2018-12-31$20,566
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$200,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$372,185
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$106,207
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$5,996
Value of net assets at end of year (total assets less liabilities)2018-12-31$700,898
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$694,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$1,003,012
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$890,809
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$890,809
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$20,566
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$125,268
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$2,711,527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$2,742,982
Contract administrator fees2018-12-31$123,825
Liabilities. Value of benefit claims payable at end of year2018-12-31$302,114
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$195,907
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MOSS ADAMS LLP
Accountancy firm EIN2018-12-31910189318
2017 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$195,907
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$690,612
Total income from all sources (including contributions)2017-12-31$4,671,123
Total of all expenses incurred2017-12-31$3,495,466
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$3,364,781
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$4,667,924
Value of total assets at end of year2017-12-31$890,809
Value of total assets at beginning of year2017-12-31$209,857
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$130,685
Total interest from all sources2017-12-31$3,199
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$716,526
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$-494,705
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,175,657
Value of net assets at end of year (total assets less liabilities)2017-12-31$694,902
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-480,755
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$890,809
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$209,857
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$209,857
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$3,199
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$130,081
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$3,951,398
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$3,729,405
Contract administrator fees2017-12-31$130,685
Liabilities. Value of benefit claims payable at end of year2017-12-31$195,907
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$690,612
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31MOSS ADAMS LLP
Accountancy firm EIN2017-12-31910189318
2016 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$690,612
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$358,531
Total income from all sources (including contributions)2016-12-31$4,946,135
Total of all expenses incurred2016-12-31$5,414,603
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$5,274,476
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$4,945,137
Value of total assets at end of year2016-12-31$209,857
Value of total assets at beginning of year2016-12-31$346,244
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$140,127
Total interest from all sources2016-12-31$998
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$739,270
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$332,081
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-468,468
Value of net assets at end of year (total assets less liabilities)2016-12-31$-480,755
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-12,287
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$209,857
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$346,244
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$346,244
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$998
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$158,125
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$4,205,867
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$4,784,270
Contract administrator fees2016-12-31$140,127
Liabilities. Value of benefit claims payable at end of year2016-12-31$690,612
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$358,531
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31MOSS ADAMS LLP
Accountancy firm EIN2016-12-31910189318
2015 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$358,531
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$721,025
Total income from all sources (including contributions)2015-12-31$6,227,598
Total of all expenses incurred2015-12-31$5,723,366
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$5,590,867
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$6,227,537
Value of total assets at end of year2015-12-31$346,244
Value of total assets at beginning of year2015-12-31$204,506
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$132,499
Total interest from all sources2015-12-31$61
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,006,935
Participant contributions at beginning of year2015-12-31$22,334
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$-362,494
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$504,232
Value of net assets at end of year (total assets less liabilities)2015-12-31$-12,287
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-516,519
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$346,244
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$99,371
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$99,371
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$61
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$140,853
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$5,220,602
Employer contributions (assets) at beginning of year2015-12-31$82,801
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$5,812,508
Contract administrator fees2015-12-31$132,499
Liabilities. Value of benefit claims payable at end of year2015-12-31$358,531
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$721,025
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MOSS ADAMS LLP
Accountancy firm EIN2015-12-31910189318
2014 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$721,025
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$686,292
Total income from all sources (including contributions)2014-12-31$4,956,018
Total of all expenses incurred2014-12-31$5,020,649
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$4,908,165
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$4,955,936
Value of total assets at end of year2014-12-31$204,506
Value of total assets at beginning of year2014-12-31$234,404
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$112,484
Total interest from all sources2014-12-31$82
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$2,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,025,985
Participant contributions at end of year2014-12-31$22,334
Participant contributions at beginning of year2014-12-31$24,369
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$34,733
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-64,631
Value of net assets at end of year (total assets less liabilities)2014-12-31$-516,519
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-451,888
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$99,371
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$128,450
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$128,450
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$82
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$132,808
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$3,929,951
Employer contributions (assets) at end of year2014-12-31$82,801
Employer contributions (assets) at beginning of year2014-12-31$81,585
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$4,740,624
Contract administrator fees2014-12-31$112,484
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$721,025
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$686,292
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MOSS ADAMS LLP
Accountancy firm EIN2014-12-31910189318
2013 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$686,292
Total income from all sources (including contributions)2013-12-31$4,826,310
Total of all expenses incurred2013-12-31$5,524,191
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$5,405,749
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$4,826,262
Value of total assets at end of year2013-12-31$234,404
Value of total assets at beginning of year2013-12-31$245,993
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$118,442
Total interest from all sources2013-12-31$48
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$2,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,056,526
Participant contributions at end of year2013-12-31$24,369
Participant contributions at beginning of year2013-12-31$35,061
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$686,292
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-697,881
Value of net assets at end of year (total assets less liabilities)2013-12-31$-451,888
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$245,993
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$128,450
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$44,028
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$44,028
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$48
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$166,523
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$3,769,736
Employer contributions (assets) at end of year2013-12-31$81,585
Employer contributions (assets) at beginning of year2013-12-31$166,904
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$4,552,934
Contract administrator fees2013-12-31$118,442
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$686,292
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MOSS ADAMS LLP
Accountancy firm EIN2013-12-31910189318
2012 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$5,008,067
Total of all expenses incurred2012-12-31$4,827,580
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$4,667,017
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$5,008,012
Value of total assets at end of year2012-12-31$245,993
Value of total assets at beginning of year2012-12-31$65,506
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$160,563
Total interest from all sources2012-12-31$55
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$844,161
Participant contributions at end of year2012-12-31$35,061
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$180,487
Value of net assets at end of year (total assets less liabilities)2012-12-31$245,993
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$65,506
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$44,028
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$65,506
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$65,506
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$55
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$181,039
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$4,163,851
Employer contributions (assets) at end of year2012-12-31$166,904
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$4,485,978
Contract administrator fees2012-12-31$160,563
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31CONNOR MCMILLON MITCHELL & SHENNUM
Accountancy firm EIN2012-12-31263195732
2011 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$4,774,368
Total of all expenses incurred2011-12-31$5,053,645
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$4,900,512
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$4,774,295
Value of total assets at end of year2011-12-31$65,506
Value of total assets at beginning of year2011-12-31$344,783
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$153,133
Total interest from all sources2011-12-31$73
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$772,585
Participant contributions at beginning of year2011-12-31$48,991
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-279,277
Value of net assets at end of year (total assets less liabilities)2011-12-31$65,506
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$344,783
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$65,506
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$67,476
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$67,476
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$73
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$189,365
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$4,001,710
Employer contributions (assets) at beginning of year2011-12-31$228,316
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$4,711,147
Contract administrator fees2011-12-31$153,133
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31CONNOR MCMILLION MITCHELL & SHENNUM
Accountancy firm EIN2011-12-31263195732
2010 : HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$4,450,355
Total of all expenses incurred2010-12-31$4,144,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$3,985,790
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$4,450,188
Value of total assets at end of year2010-12-31$344,783
Value of total assets at beginning of year2010-12-31$38,970
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$158,752
Total interest from all sources2010-12-31$167
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$866,867
Participant contributions at end of year2010-12-31$48,991
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$2,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$305,813
Value of net assets at end of year (total assets less liabilities)2010-12-31$344,783
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$38,970
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$67,476
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$38,970
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$38,970
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$167
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$209,687
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$3,583,321
Employer contributions (assets) at end of year2010-12-31$228,316
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$3,774,103
Contract administrator fees2010-12-31$158,752
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31CONNOR MCMILLON MITCHELL & SHENNUM
Accountancy firm EIN2010-12-31263195732

Form 5500 Responses for HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S

2023: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: HEALTH BENEFIT PLAN AND DENTAL BENEFIT PLAN FOR THE EMPLOYEES OF CAL FARLEY'S 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

FAIROSRX, LLC (National Association of Insurance Commissioners NAIC id number: 5251 )
Policy contract number
Policy instance 3
Number of Individuals Covered488
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $87,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberIISI 3485-23
Policy instance 2
Insurance contract or identification numberIISI 3485-23
Number of Individuals Covered292
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $143,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5723653
Policy instance 1
Insurance contract or identification number5723653
Number of Individuals Covered539
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $21,258
Total amount of fees paid to insurance companyUSD $12
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $382,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FAIROSRX, LLC (National Association of Insurance Commissioners NAIC id number: 5251 )
Policy contract number
Policy instance 3
Number of Individuals Covered537
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $90,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberIISI 3485-22
Policy instance 2
Insurance contract or identification numberIISI 3485-22
Number of Individuals Covered305
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $140,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5723653
Policy instance 1
Insurance contract or identification number5723653
Number of Individuals Covered556
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $24,373
Total amount of fees paid to insurance companyUSD $67
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $391,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,373
Amount paid for insurance broker fees67
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5723653
Policy instance 1
Insurance contract or identification number5723653
Number of Individuals Covered584
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $26,553
Total amount of fees paid to insurance companyUSD $15
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $410,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,553
Amount paid for insurance broker fees15
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberIISI 3485-20
Policy instance 2
Insurance contract or identification numberIISI 3485-20
Number of Individuals Covered335
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $147,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number1000977
Policy instance 3
Insurance contract or identification number1000977
Number of Individuals Covered335
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,513
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $35,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,513
Insurance broker organization code?3
FAIROSRX, LLC (National Association of Insurance Commissioners NAIC id number: 5251 )
Policy contract number
Policy instance 4
Number of Individuals Covered596
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $94,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FAIROSRX, LLC (National Association of Insurance Commissioners NAIC id number: 5251 )
Policy contract number
Policy instance 4
Number of Individuals Covered654
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $96,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number1000977
Policy instance 3
Insurance contract or identification number1000977
Number of Individuals Covered364
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,925
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $39,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,925
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberIISI 3485-20
Policy instance 2
Insurance contract or identification numberIISI 3485-20
Number of Individuals Covered364
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $165,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5723653
Policy instance 1
Insurance contract or identification number5723653
Number of Individuals Covered645
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $24,463
Total amount of fees paid to insurance companyUSD $4,163
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $463,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,463
Amount paid for insurance broker fees4101
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION & NON-MONETARY COMPENSATION
Insurance broker organization code?3
MAXORPLUS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number111608A2
Policy instance 2
Insurance contract or identification number111608A2
Number of Individuals Covered724
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $40,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5723653
Policy instance 1
Insurance contract or identification number5723653
Number of Individuals Covered752
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $19,698
Total amount of fees paid to insurance companyUSD $187
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $383,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,698
Amount paid for insurance broker fees126
Additional information about fees paid to insurance brokerSUPPLEMENTAL AND NON-MONETARY COMPENSATION
Insurance broker organization code?3
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberS516700
Policy instance 3
Insurance contract or identification numberS516700
Number of Individuals Covered324
Insurance policy start date2017-11-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $679
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT POLICY
Welfare Benefit Premiums Paid to CarrierUSD $6,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $679
Insurance broker organization code?5
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract numberS516700
Policy instance 2
Insurance contract or identification numberS516700
Number of Individuals Covered324
Insurance policy start date2017-11-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,888
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3888
Additional information about fees paid to insurance brokerREINSURANCE FEE
Insurance broker organization code?5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5723653
Policy instance 1
Insurance contract or identification number5723653
Number of Individuals Covered740
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $20,091
Total amount of fees paid to insurance companyUSD $2,382
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $365,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,091
Amount paid for insurance broker fees2290
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?5
INTERMEDIARY INSURANCE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 52413 )
Policy contract numberS516700
Policy instance 1
Insurance contract or identification numberS516700
Number of Individuals Covered306
Insurance policy start date2017-01-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $3,834
Total amount of fees paid to insurance companyUSD $18,711
Health Insurance Welfare BenefitYes
Other welfare benefits providedTRANSPLANT POLICY
Welfare Benefit Premiums Paid to CarrierUSD $157,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,834
Amount paid for insurance broker fees18711
Additional information about fees paid to insurance brokerREINSURANCE FEE
Insurance broker organization code?5
Insurance broker nameINSURANCE MANAGEMENT SERVICES
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberS516700
Policy instance 2
Insurance contract or identification numberS516700
Number of Individuals Covered306
Insurance policy start date2017-08-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number403114-0010
Policy instance 1
Insurance contract or identification number403114-0010
Number of Individuals Covered449
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $16
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $140,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16
Insurance broker organization code?3
Insurance broker nameINSURANCE MANAGEMENT SERVICES
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number403114-0010
Policy instance 1
Insurance contract or identification number403114-0010
Number of Individuals Covered435
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $24,781
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $132,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,781
Insurance broker organization code?3
Insurance broker nameINSURANCE MANAGEMENT SERVICES
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberSA51670
Policy instance 1
Insurance contract or identification numberSA51670
Number of Individuals Covered503
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $30,074
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $200,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,074
Insurance broker organization code?5
Insurance broker nameINSURANCE MANAGEMENT SERVICES
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberSA51670
Policy instance 1
Insurance contract or identification numberSA51670
Number of Individuals Covered436
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $27,312
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,312
Additional information about fees paid to insurance brokerCLAIMS ADMINISTRATOR
Insurance broker organization code?5
Insurance broker nameINSURANCE MANAGEMENT SERVICES
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberSA51670
Policy instance 1
Insurance contract or identification numberSA51670
Number of Individuals Covered490
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $27,619
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberSA51670
Policy instance 1
Insurance contract or identification numberSA51670
Number of Individuals Covered493
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $25,944
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,944
Additional information about fees paid to insurance brokerCLAIMS ADMINISTRATOR
Insurance broker organization code?5
Insurance broker nameINSURANCE MANAGEMENT SERVICES

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